Great News!!!

[HOLLYWOOD]

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Safilo to start opening opticals to compete with luxottica(lenscrafters). So if your looking for a job there will be more opportunities; if your looking to open your own practice it will be that much harder.

 

[Ben Chudner]

Safilo to start opening opticals to compete with luxottica(lenscrafters). So if your looking for a job there will be more opportunities; if your looking to open your own practice it will be that much harder.

I assume the "great news!!!" quote is sarcasm. On the other hand, maybe it will be good for the big box docs to have even more competition. Then their salaries will decline because there will be more docs willing to accept $59 for an eye exam. As for the private practice docs, these places are not our competition. Those docs that choose to compete against corporate are either on their way to bankruptcy, or soon will be.

 

[rpames]

I guess there are now 2 frame companies I will not be carrying.

 

[rpie]

Well-stated Ben. What I find amusing is that since sears bought Kmart LUX is offering $15 eye exams at some of the converted Kmart optical to increase visibility and bring in new business ..…

 

[Ben Chudner]

I guess there are now 2 frame companies I will not be carrying.

Ditto!

 

[Ben Chudner]

Well-stated Ben. What I find amusing is that since sears bought Kmart LUX is offering $15 eye exams at some of the converted Kmart optical to increase visibility and bring in new business ..…

It's been my experience that the patients that are attracted to those deals are what I call coupon patients. They go from one location to the next looking for the best deal for an exam. Let the "doc in a box" locations have them, I prefer patients that are loyal to my practice.

 

[HOLLYWOOD]

I assume the "great news!!!" quote is sarcasm. On the other hand, maybe it will be good for the big box docs to have even more competition. Then their salaries will decline because there will be more docs willing to accept $59 for an eye exam. As for the private practice docs, these places are not our competition. Those docs that choose to compete against corporate are either on their way to bankruptcy, or soon will be.

I have to respectfully disagree. I have plenty of patients that went to lenscrafters before they came to me. The two main reasons they come to me is b/c I take VSP or b/c I'm closer to there home.

 

[rpie]

It's been my experience that the patients that are attracted to those deals are what I call coupon patients. They go from one location to the next looking for the best deal for an exam. Let the "doc in a box" locations have them, I prefer patients that are loyal to my practice.

…. The coupon patients, YES let LUX have them…… LOL.......the most outrageous patient we had recently was a 50 Y.O. that wanted us to take a $1.00 eye exam coupon if he purchased a pair of glasses. After trying to get rid of him for about 10 –15 mins, He decided to stay and pay for our examination because he thought our receptionist reminded him of his daughter …....Oh boy….... The ridiculous part was that after being examined by my younger brother, the patient noticed his medical diploma and then asked him to throw in, at no extra charge, a Physical and digital rectal examination of his prostate because he was told a year earlier by his PCP that he had a slightly enlarged prostate. 😱 After that experience he took his diploma out of the exam room.

 

[rpames]

People looking for bargain medical care is becoming more and more popular. Now that Walmart has opened a clinic on the west coast, it is only time before people start bartering the price of medical care.

 

[Opii]

…. the patient noticed his medical diploma and then asked him to throw in, at no extra charge, a Physical and digital rectal examination of his prostate because he was told a year earlier by his PCP that he had a slightly enlarged prostate. 😱 After that experience he took his diploma out of the exam room.

What is this world coming to 😱

 

[HOLLYWOOD]

It's been my experience that the patients that are attracted to those deals are what I call coupon patients. They go from one location to the next looking for the best deal for an exam. Let the "doc in a box" locations have them, I prefer patients that are loyal to my practice.

I just found out that two of my pts. are getting glasses at lenscrafters. I feel that lenscrafters is my competition, maybe not for eye exams but for glasses.

 

[Ben Chudner]

I just found out that two of my pts. are getting glasses at lenscrafters. I feel that lenscrafters is my competition, maybe not for eye exams but for glasses.

Who cares if they went to LensCrafters for their glasses. We need to stop thinking about our offices as optical shops with a doctor. We are doctor's offices with an optical. There is a big difference. The margins on glasses will continue to shrink in your office if you try to compete with the corporate boxes. Offer the highest quality glasses at a FAIR price and educate your patients. If they choose to still leave your office for glasses, let them go. You will be more profitable in the long run when they need medical care.

 

[HOLLYWOOD]

Who cares if they went to LensCrafters for their glasses. We need to stop thinking about our offices as optical shops with a doctor. We are doctor's offices with an optical. There is a big difference. The margins on glasses will continue to shrink in your office if you try to compete with the corporate boxes. Offer the highest quality glasses at a FAIR price and educate your patients. If they choose to still leave your office for glasses, let them go. You will be more profitable in the long run when they need medical care.

I care,I make much more money from the optical than I do from medical eye care. If opticals weren't profitable you wouldn't see all the MD'S opening them in there offices.

 

[HOLLYWOOD]

Who cares if they went to LensCrafters for their glasses. We need to stop thinking about our offices as optical shops with a doctor. We are doctor's offices with an optical. There is a big difference. The margins on glasses will continue to shrink in your office if you try to compete with the corporate boxes. Offer the highest quality glasses at a FAIR price and educate your patients. If they choose to still leave your office for glasses, let them go. You will be more profitable in the long run when they need medical care.

I also want to point out that there isn't that much pathology in an optometric practice. Even the ophthalmologists that work with me don't see that much 40% including cataracts.

 

[3eb4me]

I just found out that two of my pts. are getting glasses at lenscrafters. I feel that lenscrafters is my competition, maybe not for eye exams but for glasses.

Gotta have those Anne Klein II's. My roommate just bought a pair of glasses from Lenscrafters for 400 dollars. I got mine from Wal-mart for 99, and I still think that's a lot.

 

[prettygreeneyes]

Gotta have those Anne Klein II's. My roommate just bought a pair of glasses from Lenscrafters for 400 dollars. I got mine from Wal-mart for 99, and I still think that's a lot.

You bring up an excellent point. Sometimes Lenscrafters is not the cheapest option for patients. I got a pair of Anne Kleins in December before I went to work for an optometrist and paid $350 for the frames and simple polycarbonate lenses with no other extras. The same frame and lenses would have cost me $250 full price at the optometrist's office. I didn't know any better at that point and just assumed that Lenscrafters was cheaper. I think it is critical to educate patients on how important it is to shop around for the best deal and not make any assumptions about who's cheaper.

 

[rpames]

You bring up an excellent point. Sometimes Lenscrafters is not the cheapest option for patients. I got a pair of Anne Kleins in December before I went to work for an optometrist and paid $350 for the frames and simple polycarbonate lenses with no other extras. The same frame and lenses would have cost me $250 full price at the optometrist's office. I didn't know any better at that point and just assumed that Lenscrafters was cheaper. I think it is critical to educate patients on how important it is to shop around for the best deal and not make any assumptions about who's cheaper.

You bring up a good point. I have never once seen a patient get a better price at a chain than if they were to get the same thing at my father practice. Of course they can probably get a lower price if they go to some of the chain's bargain products.

 

[Ben Chudner]

I care,I make much more money from the optical than I do from medical eye care. If opticals weren't profitable you wouldn't see all the MD'S opening them in there offices.

With all due respect, just because MD's are opening up opticals in their offices, does not mean they are profitable. MD's think they are profitable because they have seen OD's do well in the past. MD's are getting killed by Medicare so they are looking for more profit centers and that's why they open them. I bet if you look at the actual profits that the majority of MD's are making from their opticals it is much less than they thought it would be. If you want to look at trends, then look at the fact that most optometric consultants are now telling OD's to focus more on the medical side of their practices.

I did not fully articulate my point about LensCrafters not really being our competition. What I mean by that is, they (the boxes) have already beat us in the discount eyewear market. They are not our competition because we should not want those patients buying from us. Those are the patients that are looking for the cheapest pair of glasses they can find. They are the ones that only get what VSP pays for. We cannot make a profit on those patients, and so we should have no problem letting them go to the boxes. You don't see the boxes saying, wow Dr. Chudner is taking away all of our Varilux Ipseo with Crizal Alize' patients. We need to find a way to compete with him. They don't do that because they can't compete with me for those patients. Those are the patients I want. Those are the ones I can actually make a profit on. The best you can do is educate your patients on why your products are worth the extra money and let them decide. I guarantee you that it takes only one Ipseo patient to make up for 4 patients you lose to LensCrafters.

About medical eyecare, I agree there is not a lot of disease in optometric practices. I would go even farther to say that a lot of general OMD's in private practice don't even see a lot of disease. They may do a lot of cataract surgeries, but just like the MD's you work with, there is not a lot of disease in most areas for the average cataract surgeon. Just because there is not a lot of disease, however, does not mean there is not a lot of medical eyecare billing you can do. For example, there is a lot of dry eye in my area. Not the sexiest disease, and probably not one you think of when you think medical eyecare, but punctal plugs pay a lot more than a CR-39 single vision uncoated lens in a Safilo frame. And there is less overhead involved which makes the profit go up even more.

My point is that medical eyecare is not only waiting for that patient to come in with a CRVO. There are a lot of diagnostic procedures you can perform on patients with glaucoma (estimated at 12% of the population, I believe), diabetes (epidemic numbers), dry eyes, etc that will make you more money than you will in optical. My biggest fear for optometry is that those docs that refuse to move into the medical model will eventually die off due to the boxes. One last point - in the average OMD office, 70% of the patients have been seen more than once during the course of the year. You and I both know there is not that much actual disease out there.

 

[rpie]

This reminded me of a post I read earlier that stated, “ OD’s mainly do refractions all day”. I guess that may be true if you’re in the retail environment but I have many days that I will do 1 or 2 refractions. The equipment I use the most is the Slitlamp.

Glaucoma /ocular hypertension is a large part of our practice, followed by our contact lens services. Dry eye therapy is a great one because most post LASEK patient is dry. The interesting thing about plugs is that many OMD’s hate doing them so it’s a fairly wide-open field for OD’s. Over all, our experience is that if your patient base is composed of people seeing you for medical eye services they will eventually use your dispensary.

Like this morning, after finishing a 6 month glaucoma check on my patient, she decided to get 2 Paris of SRx form us. I was puzzled because although she had gotten glasses form us in the past, at her prior appointment she wanted to do the Crafters thing. She told us that the reason she would never go back to LC is because she not only ended up spending $1,100.00 for 2 pairs of glasses, they were 55 eye, rimless drilled mount frames………excellent choice for a –8.00 with a buck and half cyl. I think you all can figure out what happened when she saw her “beautiful new glasses” 🙄 . She eventually was able to return the glasses on their “love them or return them “ guarantee but only got about half of her money returned since she no longer wanted to get glasses from them.

 

[Ben Chudner]

This reminded me of a post I read earlier that stated, “ OD’s mainly do refractions all day”. I guess that may be true if you’re in the retail environment but I have many days that I will do 1 or 2 refractions. The equipment I use the most is the Slitlamp.

Absolutely true.

Glaucoma /ocular hypertension is a large part of our practice, followed by our contact lens services. Dry eye therapy is a great one because most post LASEK patient is dry. The interesting thing about plugs is that many OMD’s hate doing them so it’s a fairly wide-open field for OD’s. Over all, our experience is that if your patient base is composed of people seeing you for medical eye services they will eventually use your dispensary.

I've noticed the same thing. Believe me, I am not advocating that OD's should get rid of their dispensaries. I am merely pointing out that there are better profit centers in our offices.

 

[HOLLYWOOD]

With all due respect, just because MD's are opening up opticals in their offices, does not mean they are profitable. MD's think they are profitable because they have seen OD's do well in the past. MD's are getting killed by Medicare so they are looking for more profit centers and that's why they open them. I bet if you look at the actual profits that the majority of MD's are making from their opticals it is much less than they thought it would be. If you want to look at trends, then look at the fact that most optometric consultants are now telling OD's to focus more on the medical side of their practices.

I did not fully articulate my point about LensCrafters not really being our competition. What I mean by that is, they (the boxes) have already beat us in the discount eyewear market. They are not our competition because we should not want those patients buying from us. Those are the patients that are looking for the cheapest pair of glasses they can find. They are the ones that only get what VSP pays for. We cannot make a profit on those patients, and so we should have no problem letting them go to the boxes. You don't see the boxes saying, wow Dr. Chudner is taking away all of our Varilux Ipseo with Crizal Alize' patients. We need to find a way to compete with him. They don't do that because they can't compete with me for those patients. Those are the patients I want. Those are the ones I can actually make a profit on. The best you can do is educate your patients on why your products are worth the extra money and let them decide. I guarantee you that it takes only one Ipseo patient to make up for 4 patients you lose to LensCrafters.

About medical eyecare, I agree there is not a lot of disease in optometric practices. I would go even farther to say that a lot of general OMD's in private practice don't even see a lot of disease. They may do a lot of cataract surgeries, but just like the MD's you work with, there is not a lot of disease in most areas for the average cataract surgeon. Just because there is not a lot of disease, however, does not mean there is not a lot of medical eyecare billing you can do. For example, there is a lot of dry eye in my area. Not the sexiest disease, and probably not one you think of when you think medical eyecare, but punctal plugs pay a lot more than a CR-39 single vision uncoated lens in a Safilo frame. And there is less overhead involved which makes the profit go up even more.

My point is that medical eyecare is not only waiting for that patient to come in with a CRVO. There are a lot of diagnostic procedures you can perform on patients with glaucoma (estimated at 12% of the population, I believe), diabetes (epidemic numbers), dry eyes, etc that will make you more money than you will in optical. My biggest fear for optometry is that those docs that refuse to move into the medical model will eventually die off due to the boxes. One last point - in the average OMD office, 70% of the patients have been seen more than once during the course of the year. You and I both know there is not that much actual disease out there.

The problem that I have in my practice is that my pt. population is very young, that being said you know that there won't be much pathology. Believe you me I treat as much as I can, and I bill as much as I can. in 10 years as my pts. age I'll be in better shape.

 

[gsinccom]

I am wondering everyones thoughts on why people choose optometry as a career and if this will change as private practice optometry changes due to the pressures from corporate opticals and OMD practices. It seems many choose optometry because of not wanting to have to deal with invasive procedures or "yucky" stuff. There are some who chose it and still do cause they couldn't get into MD school. However I think the most of us are choosing it because it isn't as "yucky" as dental or medical and also because it offers the ability as does dental to be one own's boss which you have a hard time getting as an MD; many want to be a primary care eye doctor and not have to do surgery. If OD practices must become more medical to survive will this push all those who went into it to not do the "yucky" stuff into the commerical practices? Is the puncutal plug process as challenging (manual dexterity wise) as removing a foreign body? If ODs must focus on medical to survive does this mean I'll need to send my mother down the street to buy her spectacles from the corporate optical? Are ODs eventually going to serve as PAs of OMDs? Are optician schools going to provide the future ODs for corporate optical? So..will there soon be an OMD OD (OMD PA) and a corporate optical OD (optician trained into an OD)? Forgive my ignorance but please acknowledge my interest in my future profession and the direction it is heading. thanks.

 

[VA Hopeful Dr]

I am wondering everyones thoughts on why people choose optometry as a career and if this will change as private practice optometry changes due to the pressures from corporate opticals and OMD practices. It seems many choose optometry because of not wanting to have to deal with invasive procedures or "yucky" stuff. There are some who chose it and still do cause they couldn't get into MD school. However I think the most of us are choosing it because it isn't as "yucky" as dental or medical and also because it offers the ability as does dental to be one own's boss which you have a hard time getting as an MD; many want to be a primary care eye doctor and not have to do surgery. If OD practices must become more medical to survive will this push all those who went into it to not do the "yucky" stuff into the commerical practices? Is the puncutal plug process as challenging (manual dexterity wise) as removing a foreign body? If ODs must focus on medical to survive does this mean I'll need to send my mother down the street to buy here spectacles from the corporate optical? Are ODs eventually going to serve as PAs of OMDs? Are optician schools going to provide the future ODs for corporate optical? So..will there soon be an OMD OD (OMD PA) and a corporate optical OD (optician trained into an OD)? Forgive my ignorance but please acknowledge my interest in my future profession and the direction it is heading. thanks.

I don't think optical shops with OD practices will ever completely disappear. The general trend just seems to be geared more towards medical optometry with the optical shop on the side. This is a change from the past, where ODs tended to focus more on the optical side of things. Older ODs are the ones who primarily focus on the optical aspect of things. As they are retiring, optometry will see even more focus on medical optometry but still likely keep the optical part going.

 

[stompy]

There are certain areas of optometry that is only (or mostly) accessible by ODs, such as low vision and VT. As far as I know, for the most part, OMD have not explore VT as much as OD has (However, I recall someone having mentioned something about orthoptics? on this forum before?). If ODs ONLY follow after the footsteps of MD, then what you suggest might indeed happen...but some ODs, however limited number, might argue that ODs are "better"/different than MDs in that certain sense that we are much broader than OMDs.

Just my two cents.

 

[Ben Chudner]

The problem that I have in my practice is that my pt. population is very young, that being said you know that there won't be much pathology. Believe you me I treat as much as I can, and I bill as much as I can. in 10 years as my pts. age I'll be in better shape.

Hang in there then. If you have a large practice filled with young patients, you will do very well as they age.

 

[Bhartiben Patel]

nc

 

[gsinccom]

any others thoughts on medically focused ODs becoming the PAs of OMDs and the corporate optical (box store) OD positions soon being filled by opticians trained in refraction? thanks
are my options for private practice primary care optometry (as we know it now or as we have in the past) going to be so limited in 7 years (when I'd be a practicing OD) that I'll wish I'd stayed in my current career (I'm 28 now and have been working my way up in Higher Ed Administration till I thought,over the past year, that OD might be the right fit for me) <and/or applied to Law school> and not incurred $100,000 plus for an OD education debt?

 

[rpie]

The refracting Optician is possible but, as I have said in a prior post, not likely due to the cost and time needed to make it happen. First all states have to form a licensing board for opticians, then a standardized educational/certification program. (There are still states where a person can become an Optician if they are at least 18 Y.O. with no formal training) If and when this is done then, the process of getting refracting privileges begins for each state. If the big boxes wish to do this I suppose they eventually can make it happen. However, I doubt the shareholders or management will be willing to see the company’s profits being spent for this venture. 7-10 years back, LUX, Quaker Oats (they owned a chain of super optical), Sterling, and I believe Pearle, fought against a proposal requiring all opticians be licensed because costs would rise. Another thing is that of the total sales at many of these retail optical, about 70% of the optical sales are from filling out side SXs, and 30% is from the in house doc., so even if they did spend the money to get a refracting optician will it be a good ROI?

As far as an OD becoming like a PA to an OMD, that is very unlikely because although the medical treatment and management is the similarity between the two professions OMD’s are surgeons first and foremost and OD’s are Primary eye docs. Each have different training and skills that patients need. One note about ocular surgery, there is more than enough and maybe even an excess of OMD’s to meet the surgical demand. Since majority of the population sees OD’s for their eye care, making the OD the “gatekeeper”, the OMD has to look to the OD for referrals if they want their surgical practice to grow.

 

[ucbsowarrior]

The world is run by economics.

30% of you:
Those that understand how businesses are run will understand the pros and cons of both commercial and private optometry. They will also understand that there is a place for both of these practice modalities. They will understand the limitations, challenges and benefits of each. They will choose their path or paths.

70% of you:
The rest of you will be ods who are blind to the two different modalities. Blinded by rhetoric, false testimonies and flawed deductional logic. At best you will thrive in a non-competitive local market. If you are in a competitve local market you will be dog meat. Yet you must not blame the profession, the business environment or your partners or employers. You must blame yourself, for it is your ignorace that limits your growth in understanding the profession and beyond.

Last but not least, private practice in most cases allows you to practice at a higher level than commercial practices. There are fundamental reasons for this - your task is to find out what those reasons are.

Now most of you are thinking you're going to be the 30% that will understand stuff....probably not - you're just deluded.

 

[Tom_Stickel]

any others thoughts on medically focused ODs becoming the PAs of OMDs and the corporate optical (box store) OD positions soon being filled by opticians trained in refraction? thanks
are my options for private practice primary care optometry (as we know it now or as we have in the past) going to be so limited in 7 years (when I'd be a practicing OD) that I'll wish I'd stayed in my current career (I'm 28 now and have been working my way up in Higher Ed Administration till I thought,over the past year, that OD might be the right fit for me) <and/or applied to Law school> and not incurred $100,000 plus for an OD education debt?

A P.A. can only work under the supervision of an MD. They are essentially paramedical. That's why they don't have the title of doctor of ____, which in today's healthcare generally means the ability to diagnose and treat within your scope of practice without supervision.

There are ODs who are stuck working as basically PAs for OMDs, but those are often older OMDs who don't realize the potential of the employed OD. I think younger and more open-minded OMDs realize that an OD practicing full scope in their office is a big asset to them, as they get to pawn off a lot of blepharitis/Oc. HTN/DM without retinopathy that isn't lucrative or interesting for them to see.

100% agree with ucbso: if you don't fully educate yourself on what you're getting into, you just might get what you deserve.

 

[gsinccom]

I am trying so hard to educate myself on what I'm getting into.

I've seen how in many parts of the country PAs and NPs have basically taken the roles of Family Practice Docs and am worried this will happen to Optometrist. I've been in OMD offices where basically all the primary care duties are done by technicians (there are no ODs on site) and then the OMD will just come in and verify stuff (for 5 minutes) and sign the perscription. The OMD spends 2 days a week doing this and 2-3 days a week doing surgeries.

Of course, I know there are OMD offices here too where OMDs and ODs work together but it seems like if they are only paying their OD $80,000/year there are treating them similar to the way a PA is treated....am I lost?

Overall, am I just worrying too much..or do I just need to further educate myself on Optometry as some of you suggest?